In the classics of Oriental Medicine, the Nei Jing and the Shang Han Lun – which may be the oldest medical textbooks in the world – there is an elaborate theory of disease and cure. They describe how external pathogenic factors enter the being and pass through a series of bioenergetic zones in successive stages. In Oriental Medicine, mind and body are not separated. The physical body is seen as an extension or manifestation of spirit or mind and the energetic zones elaborate this integral being. When one treats the meridians zones with acupuncture or herbal medicine, one is treating the body and one is treating the mind, for all of these dimensions of the being are one.
Today with the focus on “evidence based medicine” and the isolation of specific pathological and curative factors we tend to lose sight of this broader understanding of disease and healing – even within the field of Oriental Medicine. Heiner Fruehauf describes how the Maoist development of modernized TCM – “Traditional Chinese Medicine” – eliminated this classical understanding and asserted that mind was but an epiphenomena of matter, much like the Western conception of materialist science and medicine. Western medicine’s recent return to the focus on mind as important in disease and cure of the body was inevitable not just because of its ineradicable nature but because of a change in the social and physical environment in which psychosomatic disturbance has become the primary factor in disease. Wilhelm Reich demonstrated epidemiologically as well as clinically how psychosomatic and neurotic diseases had already replaced environmental and epidemic diseases as primary cause in modern societies by the dawn of the Nineteenth Century.
Several hundred years ago, doctors in modernizing industrial societies already began to diagnose the growing pathological disturbances of the nervous system in “neuraesthenia,” “psychaesthenia,” and “hysteria,” but it was Freud who synthesized this social change into an elaborate theory and practice in the Twentieth Century. It is only now that Oriental Medical doctors in the East are being confronted with the same thing as these countries continue to modernize. But as Elisa Rossi has demonstrated, classical Oriental Medicine has a rich vocabulary for understanding and treating the mind or Shen in all its forms.
The Shang Han Lun is a theory of “cold damage.” Beyond the specific ideas of cold weather this can be conceived as “cold” shock or trauma (as confirmed by Craig Mitchell in his commentary on the classic). In this case a patient can suffer a severe shock which has not left her and is now compromising her life at a serious level.
The method of the classics is to release trauma which has penetrated the being through the energetic zones along a specific course of development. This is just as true for psychic shock as it is for physical pathogenic factors. Following a classical approach for example, one can give a patient “Si Ni Tang” from the Shang Han Lun for cold shock which has penetrated to the deepest level of the shao yin zone of the heart and kidney energy. In TCM this is also the formula for yang collapse. Caiping Tang in her classical research on clinical applications discusses how “Si Ni Tang” – and fu zi – can be used to treat psychic shock. Similarly aconite (fu zi) is used in modern homeopathic medicine equally for physical cold-induced disease and psychic shock.
The Shang Han Lun describes how when pathogenic factors penetrate to this level there is a lassitude and desire to curl up and hide from the world much as a patient in this state might wish to do: to sleep late and stay in most of the time. This condition is described as yang collapse. The patient would experience this on a psychic level though it might not be apparent on a physical level. She would have no desire or will and could not think or express herself.
This is not a very large formula but the dosages do not need to be as strong as in classical times as we are not fighting major external cold but energetically and psychically trying to remove external pathogenic shock which has become chronic as cold yang collapse in the shao yin zone. We can see here the roots of homeopathic understanding as the Nei Jing states that the treatment should be as subtle as possible, and that the stronger the formula the more it must be ceased when the patient has already started to get better yet before the process is complete.
Acupuncture too is excellent for releasing trauma but it must also be used appropriately. When treating the meridians with acupuncture one is literally treating the spirit as well. Nevertheless one can use point combinations which focus on the psychoemotional and mental aspects as well as creating intent for the transformative process. Acupuncture can be used homeopathically to bring on an encounter with the stuck trauma and an opportunity for release, rather than coercing the body allopathically to reverse the symptom.
When patients feel better after the treatments they gain hope and a desire to engage in the process of transformation. If you engage in the dialogue and exchange signifiers which give new meaning to life, eventually they begin to understand their condition better and want to explore the history of trauma as well as the deeper roots of it. This can lead to a psychoanalytic exploration of one’s condition and life. For me this is an opportunity to return to the calling of the Nei Jing to treat the shen or spirit directly with “tong shen ming” as Ted Kaptchuk inspires us to do in his re-reading of the classics. It is often a slow process but what is more precious than creating space and time in the current era. One may be very reluctant to come to full consciousness about the past, as of course this means mourning loss and psychic pain. We inevitably encounter new levels of grief as our condition changes but we become more clear and alive. One may be able to return to the world to work on oneself and begin a process of deep healing. The prognosis in this case is very difficult as change only happens very slowly but I believe over time with devotion we can emerge from trauma in a new state of being.
The classic texts of Oriental Medicine describe how pathogenic factors enter the bodymind and follow pathways to different energetic zones and organs. We might add to this as well different spiritual or mental complexes. Our own prenatal constitutional jing and shen factors may leave us vulnerable to external factors and where they end up in our bodymind. Similarly the physical and psychic traumas of our postnatal life often remain unhealed and can be triggered by similar external factors. This is what Freud calls the repetition compulsion in psychic disease. Instead of merely seeing this as a pathology we could see it as a new opportunity to heal an old trauma. In that case we need not suppress the symptom but release the deeper root of the problem.
It is my experience that classical Oriental Medicine is excellent for treating acute trauma and chronic residues of this. If we look more closely we may find that much chronic disease is but what is left over of acute disease mistreated in the first place. Trauma penetrates deeper into the body along a series of stages and levels and is likewise healed along certain pathways. The Nei Jing recommends to guide matter along its course of development. This has been echoed thousands of years later in modern homeopathic medicine and the law of disease and its cure developed by Samuel Hahnemann, as well as in the psychoanalytic theory of mental disease and cure developed by Sigmund Freud. Little did they know that the roots of this understanding were already in the classics.
Ilza Veith (ed) Nei Jing
Jing-Nuan Wu(ed) Ling Shu
Craig Mitchell (ed) Shang Han Lun
Guohui Liu (ed) Wen Bing (Warm Pathogen Diseases)
Heiner Fruehauf “All Disease Comes from the Heart” (American Acupuncturist V. 43)
Craig Mitchell “Analysis of Classical Works” ACTCM Seminar 2/08
Caiping Tang “Scholastic Schools” ACTCM Seminar 6/08
Ted Kaptchuk The Web that Has No Weaver
Ofer Baranovitch Stages, Levels, Envelopes: Integrating Classical Models
Mark Seem Bodymind Energetics
Elisa Rossi Shen: Psycho-Emotional Aspects of Chinese Medicine
Sigmund Freud Outline of Psychoanalysis
Wilhelm Reich The Cancer Biopathy
Samuel Hahnemann Materia Medica